2012 Smart Physical Therapy, PC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

025085 Issued in NY

Legal business name

2012 SMART PHYSICAL THERAPY, PC

Practice address

10119 39TH Ave
Lower Level
Corona, NY 11368-4806

Phone

(347) 669-3828

Fax

(347) 808-8326

NPI assigned

Jan 26, 2012

Last updated

May 8, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Francisco Albert Reyes

Title

Physical Therapist

Phone

(347) 669-3828

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1327536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336435200000",
    "number": "1679844302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10119 39TH AVE",
            "address_2": "LOWER LEVEL",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113684806",
            "telephone_number": "347-669-3828",
            "fax_number": "347-808-8326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10119 39TH AVE",
            "address_2": "LOWER LEVEL",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113684806",
            "telephone_number": "347-669-3828",
            "fax_number": "347-808-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2012 SMART PHYSICAL THERAPY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-26",
        "last_updated": "2012-05-08",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "FRANCISCO",
        "authorized_official_middle_name": "ALBERT",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "347-669-3828",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "025085",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "025085-1",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02761397",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Corona, NY
• Providers in Corona, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.